The Good, Medium, and Bad days checklist

One truth about both grief and chronic pain (my two areas of expertise) is that some days are good, some days are bad, and some days are neither. Categorizing the days that way isn’t my attempt to judge them, though that’s what it sounds like. Instead, it’s my way of helping my clients figure out how to manage based on what kind of day (or moment) they’re having.

I hear a lot from my clients about whether or not they’re being “productive.” This is a word I hate. You are not a factory that has to churn out a certain amount of parts every day in order to keep functioning. You are a person who sometimes has easy days and sometimes has hard ones. If you are living with chronic pain or suffering a bereavement, you are allowed to not “accomplish” something every minute of every day, or even once every day. Sometimes it’s a struggle to wash your hair or make an important phone call or exercise. It’s ok for even “easy” things to be hard. 

Easy for me to say, right? We get a lot of messages about our worth from a lot of different sources and for most of us, it boils down to this idea of productivity. I can’t undo any of that just by telling you it’s ok to have a bad day. What I can do is offer an alternative to the self-berating some people do when their pain or their grief prevents them from being productive. 

Instead of starting with judgment (“I didn’t do anything today, I’m useless, I wish I had…” etc.), start with making a list. Actually, make three lists: what can I do on a good day? What can I do on a bad day? What can I do on a medium day? A bad day might consist only of eating and drinking and brushing your teeth. A good day might be an endless list of possibilities. There’s no right or wrong, only what you are capable of doing depending on what kind of day you’re having.

This might sound kind of silly but let me explain how it can help. If the only things on the list on a bad day are tasks you’re able to complete, you cannot berate yourself for not doing more. You did the things you were able to do on this particular day. On the flip side, the list of good day activities doesn’t have to be wholly completed on a good day. It can be filled with options: a good day might mean taking a walk with a friend or sitting down to pay bills but it doesn’t have to be both of those. There will be more good days to do more things on the list. 

Changing the way we view ourselves and our worth is not a quick fix; it’s an ongoing practice made of many small habits and tasks. Instead of the usual cycle of self-recrimination, try something new. Make a list. Give yourself grace. Better days will come.

Caring for yourself as you grieve

It is easy to list for ourselves all the things we didn’t start or finish in any given day. “I should have called my sister/run a load of laundry/exercised today;” the list is endless. When we are grieving or in a depression or having big anxiety, the list also comes with some serious self-judgment: what is wrong with me? Why can’t I do anything?

In those moments, I invite you to remember that there are very few things you must do every day. You have a set of basic needs: food, water, and shelter. If you’re really feeling ambitious, you can add personal care (showering, brushing your teeth) and socialization (as much of it as you can handle; even just texting someone hello is good enough here). On days when your emotions are heavy, when you are weighed down by grief or pain, you do not have to accomplish anything except very basic self care.

Self care conjures up images of bubble baths and good chocolate. That’s lovely but it’s not what I’m talking about. I’m talking about some Maslow’s hierarchy of needs stuff. Remember your intro to sociology class? I shall refresh your memory, just in case:

See how those physiological and safety needs are at the bottom? That’s because you can’t reach the other levels without first meeting the basic needs. It’s easy to get lost in the weeds, especially when we are not well. Instead of berating yourself for not doing enough, look at what you can do: get out of bed; feed and water your body; try to connect with another human being or a pet or a plant or a book. Focus on what you need to stay alive. Everything else can be done tomorrow.

Grief before loss: Anticipatory grief

Most of the time, we think about grief in terms of a death loss. After a death, your grief may be all consuming but it’s also clear: someone you love is physically gone and their absence is painful. But sometimes we lose someone before their body dies. That grief—the more ambiguous, murky loss of loving someone who leaves us by degrees—is called anticipatory grief.

Just as it sounds, it’s the anticipation of a loss before the loss itself. Perhaps the person you love is still physically present but they’ve had a major change in their functioning. I don’t just mean dementia, although that has its own devastation. It can also be that your loved one has cancer or ALS or some other illness that is changing their mind and body over months or years. It can be that you’ve lost the person you knew to their addiction or a traumatic brain injury that’s changed their personality. The person you love is technically alive but they aren’t themselves anymore.

In some ways, anticipatory grief is even more difficult to deal with than the grief that follows a death. When someone dies, there is a clear date to point to as the “beginning” of your grief. There are milestones to mark: one month without them, six months, a year. When your loved one slowly leaves you, it’s harder to name your grief and figure out how to cope with it.

That naming is the first step. Acknowledging anticipatory grief will help you move through it. Remember, we don’t “get over” grief, no matter what kind it is; instead we learn to grow around it. Rather than trying to ignore it or avoid it, speak it aloud; share it with others; carve out the space and time to honor it. Anticipatory grief is normal, even if it’s hard to wrap your mind around, and it deserves your attention. Reach out for support; you don’t have to do this alone.

Using Emotional Intelligence to Thrive

Earlier this week, I had the pleasure of presenting to a group of professional women about emotional intelligence. They had chosen the topic and while it’s not my typical area of expertise, the idea interests me. At its core, emotional intelligence is about examining how we understand and interpret our feelings, our motivation, our interpersonal interactions. I think this is one of our lifelong jobs as human beings: to grow through self reflection and introspection.

So how does that growth occur? First, we need to have a basic understanding of how much emotional intelligence we already possess. As with all psychological concepts, there’s some debate in the psychological community about how measurable EI is. (There’s debate in the community about literally everything, to be fair). That being said, it’s pretty well accepted that emotional intelligence can be higher or lower depending on a number of factors: empathy, for instance, as well as motivation, social and self awareness, and self regulation. There are tests you can take online to get a feel for where you land in each of those aspects. Or you can take a moment and just consider: how well do you know yourself?

The reality is, honest self assessment can be tough. We all want to believe we’re naturally empathetic and intuitive, etc. But actually looking inward takes a little more work and a lot more humility than a standard, “how nice a person do you think you are?”. It takes effort to honestly face yourself and ask, how empathetic am I? How much do I let my emotions dictate my actions? What would others say about me?

A lot of my work as a therapist is encouraging people not to be so hard on themselves for having difficult feelings. So don’t get me wrong: this shouldn’t be an exercise in self flagellation. Rather, I want to encourage you to consider measuring your EI as one more way to grow. It’s all grist for the mill, as my brilliant clinical supervisor told me recently. How we understand and manage our emotions impacts our lives in numerous ways, big and small.

And if you aren’t ready to look further right this minute, you have permission to leave it alone until you are. Part of being emotionally intelligent is setting limits, even (especially) with yourself. When you are ready, I encourage you to investigate with curiosity and empathy. The path to growth doesn’t need to be all thorns. Celebrate the parts of yourself that bring and spread joy and tend to the parts that want to grow with love and compassion.

Caregiver burnout is real. And it sucks.

Caregiving is a gift. The ability to take care of someone you love, at home, with relative comfort and routine, can be a beautiful and rewarding experience. It can also be a living nightmare. Most of the time it’s both, by turns.

Caregiver burnout doesn’t just appear one day, though it can feel like that: one day you’re fine and the next day you’re not. In truth, it’s not that dramatic; instead, it creeps in over time, slowly and steadily, until one day you find yourself overwhelmed, exhausted, frayed. It can be easy to miss or ignore the signs of burnout at first because caregiving is a full-time job. Additionally, you might also have a regular job and a family and friends and you know, a life. Or you did, before you became a caregiver. Slowly those other parts of you become buried underneath the weight of being someone’s sole care provider. It’s no surprise then that one day burnout hits you like a ton of bricks, in the form of exhaustion, irritability, anxiety, guilt, a miasma of shitty feelings.

You aren’t alone and it’s not unfixable. There are, in fact, both big and small steps to take when you discover that you’re burnt out. Before we explore those though, I would be remiss if I didn’t note that there are big systemic problems here that can make accessing those solutions tricky. For instance, one solution is to hire private help. However, for many people, hiring someone to help out is simply not a choice. There are programs through the county and state that will subsidize the cost but they’re means-tested, which means you have to come in under a certain income and asset level to access those programs. The result is, a lot of people fall into the middle ground of not rich enough for private care and not poor enough for state assistance.

That being said, there are still options. Maybe you can’t afford 24 hour care but you can swing a few hours here and there so you can take a break (an old client once called this Granny sitting, a phrase I find delightful). Maybe you can call on some nearly grown grandkids or other family members to take the occasional overnight or midday shift so you can rest. Maybe you’re resistant to that idea, and for good reason. But I would encourage you not to dismiss the idea of asking for others to step up out of hand. Sometimes someone becomes so stuck in their role as a caregiver, they don’t hear the other people in their lives who are offering to help. Or they decide not to ask for fear of hearing no. But if you don’t ask, you definitely do not receive.

Beyond that, there are other, smaller remedies. Who were you before this? What brought you joy? This is important because you cannot pour from an empty cup. In order to be someone’s caregiver, you have to be in good working order yourself. Meaning it isn’t selfish to take a shower or eat a hot meal or exercise. It’s actually a necessity that you do things for yourself so that you don’t become a shell of a person who resents what started as a gift: caring for someone you love.

There’s more to say here, namely about what happens when you’re caring for someone you don’t love or even like that much. But that’s another story for another day. Today, if you’re a caregiver, I want you to consider what things you do to keep yourself healthy and sane. If you can’t think of anything, it may be time to take a real break and take stock, and yes, consider therapy. Caregiving should be a gift, not a prison sentence.

When your body betrays you

Last week, I wrote about grief. I was mostly referring to the grief we experience when someone we love dies. But there are losses throughout our life cycle that don’t necessarily have to do with death.

For the majority of my career, I’ve worked with people experiencing life-changing and often chronic illness. The prognosis doesn’t have to be terminal for the symptoms of being ill—of having a body that doesn’t do what it used to do—to be devastating and isolating. Your friends and family can’t understand what you are experiencing. It’s difficult to explain pain or fatigue or some other unquantifiable symptom to someone whose body is not sick. In a misguided attempt to help, these family members and friends may tell you that your situation isn’t as bad as it could be; that you just have to push yourself harder; that you need a second, third, fourth opinion.

Their hearts are in the right place. They’re hoping that the power of positive thinking will do the trick and cure you. But not everyone is helped by the relentless positive thinking memes that social media throws at us: believe you’ll get better and you will! Trust your body! Mind over matter! Et ceterra, et ceterra, until you start to doubt your own feelings. Among these feelings, of course, is the grief of what you have lost.

Because although you are still here, your body has betrayed you. Illness takes from us. Maybe you aren’t able to exercise anymore, or even get on the floor with your kids or grandkids. Maybe you can’t drive anymore. Or your brain fog is making it hard to concentrate at work or school or in social situations. Those are big losses to bear by yourself.

Therapy is not going to cure your illness. Further, your therapist will not be able to tell you how long you’ll be sick or if any of what you’ve lost will be returned to you. Your therapist can’t tell you that everything is going to be ok. What therapy can do is meet you where you are. You can grieve. Then you can start to rethink and rebuild your life. Then grieve some more and then rebuild some more… You can be hopeless and hopeful both at once. And you do not have to walk this path alone.